Orthopedic external fixator and method of use

ABSTRACT

An orthopedic apparatus is provided for bridging a first bone unit to a second bone unit. The apparatus is demonstrated on a finger joint, wherein one of the bones and/or ligaments and/or tendons of the joint is/are injured. A method for implanting and using the apparatus also is presented. The apparatus includes a reformably deformable span portion which is generally circular and preferably rhombic. By deforming or reforming the span portion, it can be repositioned laterally, and/or it can be rotated to allow range of rotary motion so as to promote healing.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation-in-part of:

U.S. patent application Ser. No. 12/462,807 filed 10 Aug. 2009, whichcarries Applicants' docket no. 18100 B, and is entitled ORTHOPEDICEXTERNAL FIXATOR AND METHOD OF USE.

The above referenced document is incorporated by reference herein in itsentirety.

BACKGROUND OF THE INVENTION

1. The Field of the Invention

The embodiments of the present invention relate primarily to orthopedicapparatuses, sometimes referred to as “fixators”, which organize and/orcontrol positioning at joints or fractures, and/or ranges of motion ofjuxtaposed bone units at joints. These apparatuses according to theembodiments of the present invention can be organized to impose or torelieve physical stresses associated with the bone units and/or withrelated ligaments and/or tendons. These apparatuses can be organized toall controlled rotation of the bones at the joint. In one embodiment ofthe present invention, when squeezed, the apparatus generally producesdistraction, when relaxed the apparatus general produces contraction.

For clarity the embodiments of the present invention are set forth incontext of a finger joint. It will, however, be apparent to orthopedicphysicians and surgeons and to others that the embodiments of thepresent invention have comprehensive scope for application to many, manyother joints and/or fractures, dislocations, tendon and/or ligamentinjuries and/or the like.

2. Description of the Prior Art

Joint injuries often result in displacement of components of the jointand of bone fragments that have become fractured and dislocated in theinjury (Ng, 2009), (Ellis, 2007).

In the treatment of these injuries it is often required to createtraction across a joint so that the components thereof are retained inappropriate relative dispositions during the healing process. It is alsoadvantageous in certain cases to permit gentle controlled movement orrelative rotation of the joint, which helps to mold the irregularsurfaces and prevents eventual stiffness.

Numerous innovations for fixators have been provided in the prior art,which will here be described in chronological order to show advancementin the art, and which are incorporated herein by reference thereto. Eventhough these innovations may be suitable for the individual purposes towhich they address, nevertheless, they differ from the presentinvention.

(1) U.S. Pat. No. 5,074,865 to Fahmy.

Referring now to the figures, in which like numerals indicate likeparts, and particularly to FIG. 1, which is a diagrammatic sideelevational view of the prior art distraction apparatus taught by U.S.Pat. No. 5,074,865 to Fahmy, U.S. Pat. No. 5,074,865 issued to Fahmy onDec. 24, 1991 in U.S. class 606 and subclass 54 teaches a distractionapparatus 10 for maintaining a fractured joint 12 during healing,including a pair of pins 14 for insertion into bone 16 at positionsproximal 18 to and distal 20 to the fractured joint 12, and a pair ofstainless steel wire springs 22 that are adjustably attached to the pairof pins 14 to determine and resiliently maintain the relative spacing ofpin insertions 24 into the bone 16 thus to retain the components of thefractured joint 12 during the healing process.

To provide initial distraction, unfortunately, Fahmy requires that thebones must first be manually separated before being held by theapparatus. “The insertion of the pins will take place under general orregional anaesthesia, and then while traction is applied to the fingerthe thicker of the two springs is attached to and between the pins, itsposition therealong being determined by location in the first or secondgrooves close to the finger.” [Emphasis added]. Fahmy at col. 2, lines20-25.

To alter the degree of distraction, unfortunately, Fahmy requires thatthe springs must be manually moved. “The degree of distraction can beinitially fixed and subsequently altered easily by moving the twosprings closer or spacing them further along the wires, or by adjustingthe number of turns of one or both springs between the pins.” [Emphasisadded]. 3Fahmy at col. 2, lines 30-34.

Further, the springs of Fahmy are secured to the pins by apolymer/monomer. “The springs may be secured by adding a small amount ofmixed past setting polymer and monomer where the springs are attached tothe pins * * * .” [Emphasis added]. Fahmy at col. 2, lines 38-40.

(2) International Patent Application Publication Number WO/1992/15258 toBagits et al.

International Patent Application Publication Number WO/1992/15258published to Bagits et al. on Sep. 17, 1992 in international patentclassification A61B 17/60 teaches a disposable external fixator withapparatus for receiving pins known per se bored into the fractured bonesfor fixing them. The fixing apparatus includes a fixing rod withequidistantly spaced and aligned bores near its end parts, and providedwith threaded parts at its ends. The diameters of the bores are largerthan those of the pins received in them. The fixator further includestwo stretching tubes slidably mounted onto the end parts of the fixingrod, and provided with bores of similar diameter, spacing, and positionto those of the bores of the fixing rod. Finally, an internally threadedclosing piece is shaped to facilitate the drawing and is screwed on thethreaded parts formed at both ends of the fixing rod.

(3) U.S. Pat. No. 5,207,676 to Canadell et al.

U.S. Pat. No. 5,207,676 issued to Canadell et al. on May 4, 1993 in U.S.class 606 and subclass 54 teaches an external fixator for the correctionand reduction of bone fragments, which includes a bar fastened to abiocompression system, on which bar and system are disposed the supportsfor fastening the pins inserted into the bones, the components of whichsupports are movable. A member permits the longitudinal displacement ofa clip, while the biocompression system makes a reciprocating movement.A damping member cooperates with apparatus for regulating the forceapplied, which are disposed outside the bar. Graduated markings indicatethe value of the force applied.

U.S. Pat. No. 5,376,091 to Hotchkiss et al.

U.S. Pat. No. 5,376,091 issued to Hotchkiss et al. on Dec. 27, 1994 inU.S. class 606 and subclass 55 teaches a dynamic joint support havingproximal and distal support sections, and apparatus for rigidlyconnecting each support section to bone, and a pair of hinges connectingeach support section to each other and pivoting at the joint to causemovement of the support section and its corresponding attached bonethrough the movements of flexion and extension. The hinge may be drivenin its movement by a gear mechanism that may be disengaged by way of aclutch. The dynamic joint support may also include a distractionmechanism for movement of the bones out of contact in the joint, whileallowing for an active range of motion at the joint.

International Patent Application Publication Number WO/1996/35385 toBailey et al.

International Patent Application Publication Number WO/1996/35385published to Bailey et al. on Nov. 14, 1996 in international patentclassification A61B 17/56 teaches an external fixator for securing afirst bone portion in a fixed relationship with respect to a second boneportion. The fixator includes a bone screw clamp for receiving a firstbone screw that is connected to the first bone portion and whichincludes a spherical portion. The fixator further includes a bone screwclamp that is operable to receive a second bone screw that is connectedto the second bone portion and which has a spherical portion. Thefixator also includes a connection member having a radiographic windowto permit radiographic examination of the bone fracture, as well as acantilever member operable to secure the spherical portions of the firstand second bone screw clamps to the connection member.

(6) International Patent Application Publication Number WO/1999/002097to Helland.

International Patent Application Publication Number WO/1999/002097published to Helland on Jan. 21, 1999 in international patentclassification A61B 17/66 teaches a distraction apparatus for holding afracture during the healing process. The apparatus includes screws orpins for insertion into a bone at points proximal and distal relative toa fracture site, and a pair of springs that can be connected externallybetween the screws or pins at spaced positions thereon. The springs actas an extension spring and a compression spring, respectively, betweenthe screws or pins. The springs are connected at the spaced positions atdistances relative to the bone that the springs will exert moments offorce in order to obtain a desired torque load at the fracture site.

(7) International Patent Application Publication Number WO/1999/004714to Nestorov.

International Patent Application Publication Number WO/1999/004714published to Nestorov on Feb. 4, 1992 in international patentclassification A61B 17/60 teaches an external fixator including threadedcarriers with a through hole for receiving bone implants clamped byfixing nuts. The carriers are interconnected by compression-distractionmechanisms and/or ball and socket joints.

(8) U.S. Pat. No. 5,941,877 to Viegas et al.

U.S. Pat. No. 5,941,877 issued to Viegas et al. on Aug. 24, 1999 in U.S.class 606 and subclass 55 teaches a hand fracture, burn, and contractiontreatment device that is capable of imparting a desired amount of longterm force and moment to the interphalangeal and metacarpalphalangealjoints so as to effectively combat deformity due to burn scar or trauma,to prevent and/or correct contractures, and to reduce and immobilizefractures. The device includes two axial members slidably mounted withinrespective housings and joined by a spherical joint, with a slot toprovide a selectable axis of increased range of motion. The devicepermits movement of one axial member with respect to the other axialmember in up to five degrees of freedom. The device further provides forthe adjustable mobilization of each axial member.

(9) U.S. Pat. No. 5,944,719 to Leban.

U.S. Pat. No. 5,944,719 issued to Leban on Aug. 31, 1999 in U.S. class606 and subclass 59 teaches an external fixator for setting fracturedbones, which includes a flexible, articulable column including a seriesof ball and socket members linked by a tensioning cable threadedtherethrough. Tightening the cable forces the ball and socket memberstogether and makes the column rigid. There is a mechanism for tighteningthe cable and keeping the cable in a tightened position to allow thebones to set without moving. A plurality of pivotable pin holders arearranged along the column for attaching to pins inserted into thefractured bones, thus attaching the column to the bones to be set. Thereis also a mechanism for fixing each pin holder into a rigid position sothat there can be no pivoting motion after the proper position of thefixator has been achieved.

(10) U.S. Pat. No. 5,976,125 to Graham.

U.S. Pat. No. 5,976,125 issued to Graham on Nov. 2, 1999 in U.S. class606 and subclass 32 teaches an external fixation apparatus for reductionand distraction of a joint injury, such as fracture or dislocation ofthe proximal and distal bones of a joint from a location external to thesoft tissue of a patient. The device includes a proximal fixator, adistal fixator, a proximal wire inserted through the proximal fixatorand into a proximal bone, a distal wire inserted through the distalfixator and into a distal bone, and an adjustable distraction mechanismconnecting the proximal and distal fixators.

(11) U.S. Pat. No. 6,080,153 to Mata et al.

U.S. Pat. No. 6,080,153 issued to Mata et al. on Jun. 27, 2000 in U.S.class 606 and subclass 54 teaches an articulation element for therelative positioning of fixation bars or bone pins of an externalfixator, which includes a plurality of pairs of jaws. The jaws have ontheir adjacent faces grooves that form a passage intended to receive abar or a pin. A spring is interposed between the pairs of jaws. Thegrooves that form the passage are positioned and arranged so as to havean external opening allowing the bar or bone pin to be snapped in bypressure on it, from the opening of the jaw into the passage, andagainst the spring force that presses the adjacent faces of the jawsagainst one another. This force holds the articulation element on thebars or pins before locking of the articulation by way of a clampingshaft.

(12) U.S. Pat. No. 6,162,223 to Orsak et al.

U.S. Pat. No. 6,162,223 issued to Orsak et al. on Dec. 19, 2000 in U.S.class 606 and subclass 59 teaches a joint fixator apparatus thatconforms to the natural axis of rotation of the joint in question, suchas a patient's wrist or knee, to avoid the possibility of bone fragmentdisplacement and/or fracture reduction. The apparatus includes twofixation rod sections or shaft sections with a spring moduletherebetween. The spring module is in the form of a flexible couplerthat connects to respective ends of the external fixator rod. The modulecan include a removable clip to restrain the motion of the spring adesired amount, such as before healing takes place. The rods can be usedto hold pin clamps that then hold bone pins for attachment to selectedbones of the patient, such as above and below a joint or above and belowa fracture. The pin clamps can be moved along the rod sections toprovide distraction of the joints for a ligamentotaxis effect inreducing the fracture.

(13) U.S. Pat. No. 6,162,224 to Huebner.

U.S. Pat. No. 6,162,224 issued to Huebner on Dec. 19, 2000 in U.S. class606 and subclass 59 teaches a bone fixator for repairing fractures ofthe distal radius and wrist. It includes, in the preferred embodiment,at least two generally parallel, spaced-apart elongate distal mountingpins with lower ends for mounting in the metacarpal bone and at leasttwo generally parallel, spaced-apart elongate radial mounting pins withlower ends for mounting in the radius. A distal pin clamp assemblysecures the distal pins to an elongate distal member. The clamp assemblyand pins are movably coupled to the distal member for translationalmovement along its elongate axis and pivotal motion about a pivot axisgenerally perpendicular to the elongate axis of the distal member andthe elongate axes of the distal pins. A pin mounting carriage holds theradial pins, and an elongate medial assembly is connected at one end tothe pin mounting carriage for independent translational motion along anaxis generally perpendicular to the elongate axes of the proximalmounting pins and the elongate axis of the medial assembly and coupledat the opposed end through a ball joint to the distal member.

(14) U.S. Pat. No. 6,171,309 to Huebner.

U.S. Pat. No. 6,171,309 issued to Huebner on Jan. 9, 2001 in U.S. class606 and subclass 57 teaches a bone fixator for repairing fractures ofthe distal radius and wrist. It includes, in the preferred embodiment,at least two generally parallel spaced-apart elongate distal mountingpins with lower ends for mounting in the metacarpal bone and at leasttwo generally parallel spaced-apart elongate radial mounting pins withlower ends for mounting in the radius. A distal pin clamp assemblysecures the distal pins to an elongate distal member. The clamp assemblyand pins are movably coupled to the distal member for translationalmovement along its elongate axis and pivotal motion about a pivot axisgenerally perpendicular to the elongate axis of the distal member andthe elongate axes of the distal pins. The fixator further includes aproximal pin mounting block for securing the radial pins and an elongatemedial assembly of adjustable length. The medial assembly is pivotallyconnected at one end to the pin mounting block for independent pivotalmotion about an axis generally parallel to the elongate axes of theproximal mounting pins and coupled at the opposed end through a balljoint to the distal member.

(15) U.S. Pat. No. 6,203,548 B1 to Helland.

U.S. Pat. No. 6,203,548 B1 issued to Helland on Mar. 20, 2001 in U.S.class 606 and subclass 105 teaches a distraction apparatus for holding afracture during the healing process. The apparatus includes screws orpins for insertion into a bone at points proximal and distal relative toa fracture site, and a pair of springs that can be connected externallybetween the screws or pins at spaced positions thereon. The springs actas an extension spring and a compression spring, respectively, betweenthe screws or pins. The springs are connected at the spaced positions atdistances relative to the bone that the springs will exert moments offorce in order to obtain a desired torque load at the fracture site.

(16) U.S. Pat. No. 6,235,029 B1 to Faccioli et al.

U.S. Pat. No. 6,235,029 B1 issued to Faccioli et al. on May 22, 2001 inU.S. class 606 and subclass 54 teaches an orthopaedic device for thegradual correction of angular and longitudinal defects of elongatedbones, which includes at least one first clamp for a first group ofscrews insertable in a proximal portion of a bone, at least one secondclamp for a second group of screws insertable in a distal portion of thebone, and a longitudinal guide bar positioned externally of the limb tobe corrected for slidably supporting the clamps. At least one of theclamps is selectively orientable about a substantially transverse axisfor carrying out angular corrections of the bone. Acompression/distraction device is movably coupleable with the clamps forcarrying out longitudinal corrections of the bone. The orientably clampis adjustable angularly in a predetermined geometric plane, as well asadjustable transversely for the group of bone screws carried by theclamp parallel to themselves for compensating for the lateral movementinduced by the angular correction.

(17) United States Patent Application Publication Number US 2001/0049525A1 to Slocum.

United States Patent Application Publication Number US 2001/0049525 A1published to Slocum on Dec. 6, 2001 in U.S. class 606 and subclass 54teaches a joint support attachable to a limb of an animal to limitmovement of an associated limb joint substantially about a single axis.The joint support includes a radial element having a longitudinal axisand a transverse element having a longitudinal axis. The transverseelement is pivotally connected to the radial element about an axis ofrotation. The longitudinal axis of the radial element substantiallyintersects with the axis of rotation, and radial rotation of the radialelement is restricted about the axis of rotation. The longitudinal axisof the transverse element is partially fixed relative to the radialelement so that it is substantially coplanar with the longitudinal axisof the radial element and substantially offset from the axis ofrotation.

(18) United States Patent Application Publication Number US 2001/0051806A1 to Ballier.

United States Patent Application Publication Number US 2001/0051806 A1published to Ballier on Dec. 13, 2001 in U.S. class 606 and subclass 54teaches a fixation device with clamping jaws and with rods connectingthe clamping jaws. The rods are adjustable axially and angularly forpositioning relative to the clamping jaws and clampable in the desiredposition, and with fixation and retaining pins that are receivable in aclampable fashion in the clamping jaws. A fixation pin applicator can beconnected in a releasable fashion to the clamping jaws. A fixation pincan be brought into a desired position by way of the fixation pinapplicator.

(19) United States Patent Application Publication Number US 2002/0004659A1 to Boudard et al.

United States Patent Application Publication Number US 2002/0004659 A1published to Boudard et al. on Jan. 10, 2002 in U.S. class 606 andsubclass 54 teaches a fixator including a rigid bar, two pin-holderassemblies that can be moved relative to this bar, and apparatus withwhich it is possible to immobilize each pin-holder assembly in a definedposition relative to the bar. The bar has a cylindrical main part and aspherical part at one end. A first pin-holder assembly includes aone-piece body with a bore passing through it to permit its engagementby sliding on the cylindrical part of the bar. The second pin-holderassembly includes a one-piece body in which a recess is formed. Thisrecess has a zone of partially spherical shape with a radius slightlygreater than that of said spherical part. This zone can receive thisspherical part with pivoting, without lateral play, and with apossibility of articulation of the second pin-holder assembly.

(20) U.S. Pat. No. 6,340,361 B1 to Kraus et al.

U.S. Pat. No. 6,340,361 B1 issued to Kraus et al. on Jan. 22, 2002 inU.S. class 606 and subclass 59 teaches an external fixator system thatincludes a clamp adapted to couple a fixator pin to a connecting rod.The clamp includes a slot for transversely receiving the connecting rod.A bolt is inserted through a bore passing transversely to the slot toengage a pin connector holding a fixator pin. The pin connector has arod-engaging surface that wedges the connecting rod into the slot, thusincreasing the clamp's rigidity by preventing rotation of the clamparound the rod and rotation of the pin connector in the clamp body. Anaiming device attaches to at least two connecting rods to guide theinsertion of fixator pins between the rods. The aiming device isadjustable to accommodate various distances between the rods and hasdifferent modes of attachment to the rods to enable the clampinstallation either above or below the rods.

(21) United States Patent Application Publication Number US 2002/0013584A1 to Termaten.

United States Patent Application Publication Number US 2002/0013584 A1published to Termaten on Jan. 31, 2002 in U.S. class 606 and subclass 54teaches a fixing device for orthopedic applications. At least onecoupling member is mounted in the connecting rod of, or the guiding rodfor, the clamping members, and intended for receiving orthopedic pins.The coupling member can be brought into a rigid or a flexible couplingposition. Further, preferably, it has been provided for that in theflexible coupling position, the flexibility can be adjusted across acertain range.

(22) U.S. Pat. No. 6,358,255 B1 to Testa.

U.S. Pat. No. 6,358,255 B1 issued to Testa on Mar. 19, 2002 in U.S.class 606 and subclass 105 teaches a device especially forosteodistraction, configured for attachment to different bone parts thathave been separated, and that are bound together by the device thatholds the bones parts in a pre-set position and/or simultaneously exertspressure for distancing or bringing together the bone parts. The deviceincludes at least two elements configured for fastening to two boneparts that are separate from each other. The two elements are coupledtogether and movable along at least one pre-set direction, there beinginserted between them an elastic element for providing a thrust in thedistancing or traction direction. The device may be removably coupled tothe bone parts to facilitate installation.

(23) United States Patent Application Publication Number US 2002/0115998A1 to Schoenefeld.

United States Patent Application Publication Number US 2002/0115998 A1published to Schoenefeld on Aug. 22, 2002 in U.S. class 606 and subclass59 teaches an external fixator for securing a first bone portion in afixed relationship with respect to a second bone portion, which includesa longitudinally extending rod and a bone screw clamping assembly. Thebone screw clamping assembly receives at least one bone screw. The bonescrew clamping assembly is mounted to the rod for relative universalmovement about a point through which the rod passes, and is normallypermitted to longitudinally translate along an axis defined by the rod.

(24) United States Patent Application Publication Number US 2003/0009167A1 to Wozencroft.

United States Patent Application Publication Number US 2003/0009167 A1published to Wozencroft on Jan. 9, 2003 in U.S. class 606 and subclass55 teaches a device that immobilizes bones of a patient, such as asurgically exposed femur and tibia, during a knee replacement operation.The device has a vertical frame including a pair of first members and atleast one second member bracing the first members. A support mechanismis mounted on the first members to permit adjustment of the height ofthe support mechanism. A first and second series of cantilever membersare supported by the support mechanism. First and second bone engagementmechanisms are mounted on respective cantilever members and engage apatient's surgically exposed first and second bones.

(25) United States Patent Application Publication Number US 2003/0191466A1 to Austin et al.

United States Patent Application Publication Number US 2003/0191466 A1published to Austin et al. on Oct. 9, 2003 in U.S. class 606 andsubclass 54 teaches devices and methods for aligning fragments of afractured bone or for positioning bones. In some embodiments, fixationdevices and anatomical features are modeled with the aid of a computer,and the model is used to determine how an actual fixation device shouldbe configured to align or position the bones.

(26) United States Patent Application Publication Number US 2003/0225405A1 to Weiner.

United States Patent Application Publication Number US 2003/0225405 A1published to Weiner on Dec. 4, 2003 in U.S. class 606 and subclass 54teaches an external fixator that includes a main body and an outriggerfor extending over a fractured joint, such as a wrist joint. The mainbody can be positioned next to a right arm or flipped over andpositioned next to a left arm. The outrigger is attachable to extendeither to the left or to the right of the main body, as appropriate. Adistal body is removably connectable to the distal end of the main body,and the distal body can be affixed to bone on the opposite side of thefracture to immobilize the joint where the fracture occurs. The distalbody is connected to the main body with an adjustable securement sectionthat provides six degrees of adjustment freedom. The outrigger isattached to the main body through a slide plate in a dual railconfiguration that provides two dimensions of adjustment. Fragment pinsupports ride in a track of the outrigger and provide seven degrees ofadjustment freedom for directed fixation of fragments at the fracturesite. The major components of the fixator are molded of plastic. Asurgical technique using the fixator includes immobilizing the joint foran initial healing duration and retaining fragment pins in place duringa secondary healing duration.

(27) United States Patent Application Publication Number US 2003/0225406A1 to Weiner et al.

United States Patent Application Publication Number US 2003/0225406 A1published to Weiner et al. on Dec. 4, 2003 in U.S. class 606 andsubclass 54 teaches an external fixator that includes a main body and anoutrigger for extending over a fractured joint, such as a wrist joint.The main body can be positioned next to a right arm or flipped over andpositioned next to a left arm. The outrigger is attachable to extendeither to the left or to the right of the main body, as appropriate. Adistal body is removably connectable to the distal end of the main body,and the distal body can be affixed to bone on the opposite side of thefracture to immobilize the joint where the fracture occurs. The distalbody is connected to the main body with an adjustable securement sectionthat provides six degrees of adjustment freedom. The outrigger isattached to the main body through a slide plate in a dual railconfiguration that provides two dimensions of adjustment. Fragment pinsupports ride in a track of the outrigger and provide seven degrees ofadjustment freedom for directed fixation of fragments at the fracturesite. The outrigger is pivotally adjustable relative to the main bodyand includes track portions separated by a wrap around angle. The majorcomponents of the fixator are molded of plastic. A surgical techniqueusing the fixator includes immobilizing the joint for an initial healingduration and retaining fragment pins in place during a secondary healingduration.

(28) United States Patent Application Publication Number US 2003/0225407A1 to Estrada, Jr.

United States Patent Application Publication Number US 2003/0225407 A1published to Estrada, Jr. on Dec. 4, 2003 in U.S. class 606 and subclass54 teaches a fixator that is an apparatus for repairing fractures of thedistal radius and wrist. Distal, pivot, distraction, and radial membersprovide an anatomically contoured, radiolucent apparatus that permitsthe wrist to move through a substantially normal range of motion.Apparatus for distraction of the bones by the fixator is also provided.The fixator may be affixed to the lower arm and hand by spaced-apartelongate distal mounting pins with lower ends adapted or mounting in themetacarpal bone and by spaced-apart elongate radial mounting pins withlower ends adapted for mounting in the radius.

(29) United States Patent Application Publication Number US 2004/0044344A1 to Winquist et al.

United States Patent Application Publication Number US 2004/0044344 A1published to Winquist et al on Mar. 4, 2004 in U.S. class 606 andsubclass 54 teaches an external fixation or adjustable frame structure.A frame structure is retained in any assembled configuration in order toallow final adjustments to be made prior to the final securement of theframe assembly in the precisely desired configuration by closure of eachclamp member. In this way, an entire frame assembly is capable of beingconstructed, adjusted, and readjusted in order to assure each componentis oriented in the precisely desired position prior to final closure ofthe clamping members. In one preferred embodiment, the clamping membersemployed in the frame structure incorporate friction pins internallymounted in each clamp, and which engage the rod member once this rod isinserted into the jaws of the clamp. In this way, any rod memberinserted into the clamping jaws contacts the surface of the jaws and thefriction pin preventing the rod member from sliding or moving relativeto the clamp. In addition, by incorporating a uniquely constructed,moving wedge plate that is adjustably engageable with any cooperatinganchor pin, secure affixation of the mounting member with the anchorpins of any diameter is achieved regardless of the orientationconfiguration or diameter of the anchor pin.

(30) U.S. Pat. No. 6,716,212 B1 to Pickens.

U.S. Pat. No. 6,716,212 B1 issued to Pickens on Apr. 6, 2004 in U.S.class 606 and subclass 54 teaches a universal modular external fixationsystem for immobilizing bone fragments in long bone fractures. Theuniversal modular external fixation system includes a frame assemblyincluding a plurality of pins to be coupled to various portions of afractured bone. The external sections of the pins are fixated to avariety of different coupling devices to attach to a series ofconnecting bars along the length of the fractured bone. A plurality ofconnecting members interconnect the connecting bars, thereby securingthe pins, and thus the bone sections, to aid in proper healing of thefracture(s).

(31) United States Patent Application Publication Number US 2004/0097944A1 to Koman et al.

United States Patent Application Publication Number US 2004/0097944 A1published to Koman et al. on May 20, 2004 in U.S. class 606 and subclass72 teaches a fixation device for treatment of orthopedic indications.The device, preferably, includes a first portion and a second portionthat may be incrementally and independently articulated relative to eachother to promote healing of an orthopedic indication. One or more wormgear assemblies may be used to incrementally adjust articulation of thefirst portion and the second portion relative to each other.

(32) United States Patent Application Publication Number US 2004/0116925A1 to Gill et al.

United States Patent Application Publication Number US 2004/0116925 A1published to Gill et al. on Jun. 17, 2004 in U.S. class 606 and subclass54 teaches a frame for attaching to a patient, a stereoguide, and amember for attaching to a patient. A method for manufacturing the frame,member, and stereoguide is also provided. The frame, member, andstereoguide are constructed from a composite material including a matrixmaterial and electromagnetically inert fibres.

(33) United States Patent Application Publication Number US 2004/0133199A1 to Coati et al.

United States Patent Application Publication Number US 2004/0133199 A1published to Coati et al. on Jul. 8, 2004 in U.S. class 606 and subclass54 teaches an external fixation device having a carrying structure ofinterconnected elements, which includes an extendible central body, andclamps for bone screws, respectively, articulated on opposed ends of thecentral body. The central body includes two parts telescoping slidableone on the other. Each of the parts include a first portion of elongateshape formed integrally with a second end portion of substantiallycylindrical shape. The first portions of the parts are slidably coupledto each other by way of a driving groove formed longitudinally in onefirst portion and a corresponding slide formed longitudinally in theother first portion, and apparatus is provided in the parts for stoppingtheir sliding movement, which is characterized in that it furtherincludes at least one plate having a predetermined contour shape andthickness, at least one recess formed on the surface of at least one ofthe interconnected elements and having its contour shape matching thecontour shape of the at least one plate, and apparatus for releasablysecuring the at least one plate in the at least one recess.

(34) United States Patent Application Publication Number US 2004/0133200A1 to Ruch et al.

United States Patent Application Publication Number US 2004/0133200 A1published to Ruch et al on Jul. 8, 2004 in U.S. class 606 and subclass54 teaches an apparatus to reduce bony fragments and maintain a human'swrist or hand in a healing position. The apparatus may include a firstclamp assembly operable to removably mount to an external fixator whenthe external fixator is coupled to a first bone of a human. A secondclamp assembly may be releasably engaged with at least one bone pinembedded in a second bone of a human. A connector rod may be provided tojoin the first clamp assembly to the second clamp assembly.

(35) United States Patent Application Publication Number US 2004/0138659A1 to Austin et al.

United States Patent Application Publication Number US 2004/0138659 A1published to Austin et al. on Jul. 15, 2004 in U.S. class 606 andsubclass 54 teaches apparatuses and methods for externally fixing andprecisely adjusting fractures, such as fractures near the ankle. In oneembodiment, an external fixation apparatus includes a first memberattachable to a first bone segment through pins and a second membercoupled to the first member through a lockable ball joint. First andsecond ends of the second member may be translated transversely relativeto a longitudinal axis of the second member, and a pin clamp is coupledto and rotatable about the second member through a lockable joint andattachable to a second bone segment. The pin clamp and the second membermay be releasably coupled.

(36) United States Patent Application Publication Number US 2005/0015087A1 to Walulik et al.

United States Patent Application Publication Number US 2005/0015087 A1published to Walulik et al on Jan. 20, 2005 in U.S. class 606 andsubclass 54 teaches a frame assembly for an external fixation device andassociated method. The frame assembly includes a first arc segment and asecond arc segment. The first arc segment is for interconnection to afirst bone portion. The second arc segment is for interconnection to asecond bone portion. The first arc segment is coupled to the second arcsegment for controlled relative rotation.

(37) United States Patent Application Publication Number US 2005/0038425A1 to Werding et al.

United States Patent Application Publication Number US 2005/0038425 A1published to Werding et al. on Feb. 17, 2005 in U.S. class 606 andsubclass 54 teaches a device for externally immobilizing broken bones,particularly, bones of the extremities. Interspaced bone pins providedfor insertion into the bone while passing through the skin andsoft-tissue mantle are arranged on a multi-articulation rod. Thismulti-articulation rod can be placed on the outside of the body whileextending along a broken bone, and includes elements that areinterconnected in a ball-and-socket type manner, which can be fixed inselected relative positions. The elements have a ball on one end and aball socket on the other end. The ball of one element is located insidethe ball socket of an adjacent element. The ball and ball socket eachgeometrically extend over more than one hemisphere, and the surfaces ofthe ball and ball socket are roughened.

(38) United States Patent Application Publication Number US 2005/0085810A1 to Lutz et al.

United States Patent Application Publication Number US 2005/0085810 A1published to Lutz et al. on Apr. 21, 2005 on U.S. class 606 and subclass54 teaches an external fixation system having clamps, rods, and pinshaving anti-magnetic core parts and a non-conductive sheath partcovering essentially the exterior surfaces of the core part. The rods,pins, and clamps are especially MRI safe for a patient when used in anyframe configuration for fractures of the upper and lower extremities andpelvis. The usual MRI field parameters of a static field of 2 Tesla, atime-varying filed of max. 20 Tesla/sec, and a specific absorption rate(SAR) of max. 0.4 Watts/kg averaged over the whole body of the patientapply.

(39) United States Patent Application Publication Number US 2005/0085811A1 to Peckitt.

United States Patent Application Publication Number US 2005/0085811 Alpublished to Peckitt on Apr. 21, 2005 in U.S. class 606 and subclass 55teaches a spiral distraction device including anchoring apparatus forattachment of the device to each side of a patient's existing mandible.A conjoined intermediate bar attaches to and transports moveable bonepieces on each side of the patient's mandible towards each other in aspiral vector that is larger than the patient's anatomical mandiblecontour.

(40) International Patent Application Publication Number WO/2005/044117to Biedermann et al.

International Patent Application Publication Number WO/2005/044117published to Biedermann et al. on May 19, 2005 in international patentclass A61B 17/70 teaches an elastic element that is used in astabilizing device for bones or vertebrae. The elastic element isembodied as a substantially cylindrical member having a first end and anopposite second end. At least one of the opposite ends of thecylindrical member is provided with a coaxial bore that includes afemale thread that is connected to a shaft and/or a head of a bone screwor rod section.

(41) United States Patent Application Publication Number US 2005/0113829A1 to Walulik et al.

United States Patent Application Publication Number US 2005/0113829 A1published to Walulik et al. on May 26, 2005 in U.S. class 606 andsubclass 54 teaches an external fixation device that includes a frameassembly having a first arc segment and a second arc segment. The firstarc segment is for interconnection to a first bone portion. The secondarc segment is for interconnection to a second bone portion. The firstarc segment is coupled to the second arc segment for relative rotation.The external fixation assembly additionally includes an articulatingmodule. The articulating module includes a central member, a first pivotsegment, and a second pivot segment. The first pivot segment is coupledto the central member for driven rotation about a first pivot axis. Thesecond pivot segment is coupled to the central member for drivenrotation about a second pivot axis. The second pivot axis issubstantially perpendicular to the first pivot axis.

(42) U.S. Pat. No. 6,908,467 B2 to Ip et al.

U.S. Pat. No. 6,908,467 B2 issued to Ip et al. on Jun. 21, 2005 in U.S.class 606 and subclass 72 teaches a fixation device for internally orexternally fixing fractures, which includes at least one nitinol wirehaving an S-shaped section and two ends. Each of the two ends forms ahook for hooking into a bone section of a fractured bone. This devicecan be made from nitinol that has a transformation temperature between25.degree. C. and 35.degree. C. In addition, this device can have adiameter between 0.6 mm and 5 mm. The device can be inserted using thefollowing process that starts by cooling the wire below a transfertemperature so that the nitinol wire forms in a martensite state. Next,the nitinol wire is inserted into a interphalangeal bone underneath apatients skin. Next, the nitinol wire heats up inside a patients bodyabove the transfer temperature. Finally, the wire transforms from amartensite state to an austenite state wherein the nitinol wireelongates in a longitudinal direction to generate a distraction force.

(43) United States Patent Application Publication Number US 2005/0149018A1 to Cooper et al.

United States Patent Application Publication Number US 2005/0149018 A1published to Cooper et al. on Jul. 7, 2005 in U.S. class 606 andsubclass 54 teaches an external foot/ankle fixation device having aone-piece frame component and a positionable cross bar that allows theattachment of generally anterior/posterior directed fixation wires orrods emanating from the foot/ankle of a patient. The external fixationdevice provides a stable fixation platform, both in-plane andout-of-plane of the object of fixation, e.g. foot or ankle. The fixationdevice through the cross bar also provides various degrees of angulationof anterior/posterior directed wires in two planes. Posterior angulationcomponents may be provided to the posterior portion of the framecomponent, which provide additional fixation wire/rod angulationvariations. Compression rails may also be provided. An optional elevatorcomponent may be attached to the bottom of the frame component, whichdoes not obstruct access to the soft tissues on the bottom of the foot.The elevator component protects the bottom of the foot from contaminatedsurfaces.

(44) United States Patent Application Publication Number US 2005/0165394A1 to Boyce et al.

United States Patent Application Publication Number US 2005/0165394 A1published to Boyce et al. on Jul. 28, 2005 in U.S. class 606 andsubclass 54 teaches a method of and system for attaching an orthopedicmember to bone. The orthopedic member is positioned with respect to abone segment. A plurality of pins are then driven through the orthopedicmember and into the bone segment to secure the orthopedic member to thebone segment.

(45) United States Patent Application Publication Number US 2005/0203509A1 to Chinnaian et al.

United States Patent Application Publication Number US 2005/0203509 A1published to Chinnaian et al. on Sep. 15, 2005 in U.S. class 606 andsubclass 54 teaches a fixation device employed to affix two or moresegments of bone in a desired spatial relationship. Embodiments of thefixation device secure and maintain a bone fracture or fractures inproper alignment during the healing process, as well as permit slightmovement or micro-motion therebetween to promote healing. In someapplications, embodiments of the fixation device place the bone segmentsunder continuous and adjustable compression or distraction, while stillallowing slight movement or micro-motion at the bone segment interface.

(46) United States Patent Application Publication Number US 2005/0234452A1 to Malandain.

United States Patent Application Publication Number US 2005/0234452 A1published to Malandain on Oct. 20, 2005 in U.S. class 606 and subclass61 teaches an implantable medical device and methods of use thereof forsupporting a structure. The structure supported can include a bonystructure. The device includes a support element having a top portion,and a bottom portion having a bottom surface and one or more aperturespassing therethrough. The bottom surface of the support element includesa receiver configured to receive a plurality of anchor assemblies. Eachof the anchor assemblies includes apparatus for locking the anchorassembly to the support element, and a base having a head and apparatusfor locking the base to the anchor assembly. When assembled, the head ofthe base for the anchor assembly may not pass through the supportelement.

(47) United States Patent Application Publication Number US 2005/0251135A1 to Riccione et al.

United States Patent Application Publication Number US 2005/0251135 A1published to Riccione et al. on Nov. 10, 2005 in U.S. class 606 andsubclass 54 teaches an external fixation assembly for bone fusion. Theassembly includes an extension arm having a fixation joint portion and apin element moveably disposed along the extension arm defining a firstjoint portion. The assembly further includes a plurality of connectingpins for bone fusion. Each of the connecting pins is configured toengage with bone matter for bone fusion and to singly attach to one ofthe joint portions for support.

(48) United States Patent Application Publication Number US 2006/0015101A1 to Warburton et al.

United States Patent Application Publication Number US 2006/0015101 A1published to Warburton et al. on Jan. 19, 2006 in U.S. class 606 andsubclass 62 teaches an intramedullary fixation assembly usable withdifferent long bone types and a guide assembly for guiding deployment ofthe intramedullary fixation assembly. The intramedullary fixationassembly includes a fixation member that has ends and a curved bodyextending between the ends. The curved body of the fixation member has aradius of curvature configured to extend through the medullary canalregardless of the long bone anatomy. Fasteners fix the fixation memberto the bone fragments and are guided by a guide assembly. The guideassembly includes a guide body defining openings configured to guide thefasteners through openings defined in the fixation member and into thebone fragments. A fixation end of the guide body includes a pair ofopposing, converging surfaces that are configured to engage in apositive fit, with an exposed end of the fixation member accessiblethrough the side aperture in the first fragment.

(49) International Patent Application Publication Number WO/2006/068682to Greenhalgh et al.

International Patent Application Publication Number WO/2006/068682published to Greenhalgh et al. on Jun. 29, 2006 in international patentclass A61B 17/60 teaches an expandable support device and methods ofusing the expandable support device. The expandable support device canbe rotatably and inflatably deployed by a deployment tool. Thedeployment tool can engage a notch on the expandable support device anddeliver a torque to the expandable support device. The deployment toolcan inflate and expand the expandable support device.

(50) United States Patent Application Publication Number US 2006/0184169A1 to Stevens.

United States Patent Application Publication Number US 2006/0184169 A1published to Stevens on Aug. 17, 2006 in U.S. class 606 and subclass 54teaches a system for stabilizing bone. The system includes a fixingblock, a pin having a far end that is adapted to be fixed directly intobone and a near end that enters the fixing block, and a frame on whichthe fixing block is fixable. The pin enters the fixing block in anon-orthogonal manner in order to permit the pin to enter the bone withan orientation that is non-orthogonal to the bone's surface, therebypermitting the pin to engage more of the bone.

(51) International Patent Application Publication Number WO/2006/092863to Nakamura et al.

International Patent Application Publication Number WO/2006/092863published to Nakamura et al. on Sep. 8, 2006 in international patentclass A61B 17/60 teaches an external wound fixing device that allows abone and a bone piece to be moved freely and deformation thereof to becorrected. The external wound fixing device includes a pair of holdingmembers for holding/securing rod-like members that are inserted,respectively, into a first part and a second part of a bone on oppositesides of a virtual fulcrum, and a coupling member for coupling theholding members. The virtual fulcrum is determined by any one of thecenter of deformation, the center of rotation of bone pieces holding afracture part or a correction bone cut part between them, and themovable center of a joint part. The coupling member has a pair of armsfixed rotatably to one end of each of the holding members, respectively,and the pair of arms are coupled rotatably. Rotational axes of thesearms are directed toward the virtual fulcrum.

(52) United States Patent Application Publication Number US 2006/0217710A1 to Abdou.

United States Patent Application Publication Number US 2006/0217710 A1published to Abdou on Sep. 28, 2006 in U.S. class 606 and subclass 54teaches skull fixation assemblies and corresponding components. Theassemblies include a multi-axial occipito-cervical connection systemthat enables elongate interconnectors, such as rods, to be coupled in amanner that permits relative movement in one or more planes. The systemincludes a locking mechanism that can be actuated to lock the relativepositions of the elongate interconnector.

(53) United States Patent Application Publication Number US 2006/0235383A1 to Hollawell.

United States Patent Application Publication Number US 2006/0235383 A1published to Hollawell on Oct. 19, 2006 in U.S. class 606 and subclass54 teaches a fixator for use in the reconstruction of acute, chronic,and traumatic injuries to the upper and lower extremities. The fixatorhas a clamping system that allows for the snapping in of pins and rails,and for multi-planar fixation of bones.

(54) United States Patent Application Publication Number US 2006/0271043A1 to Gonzalez.

United States Patent Application Publication Number US 2006/0271043 A1published to Gonzalez on Nov. 30, 2006 in U.S. class 606 and subclass 55teaches a user-attached, manually operated, fluid-driven arm lift devicefor people who have difficulties in lifting an arm unassisted, whichincludes a base support member adapted to fit about a portion of a siderib area of a human, a base support member attachment mechanismconnected to the base support member and adapted to removably attach thebase support member to the human, an arm support member having a top endand having a bottom end and being hingedly connected to the base supportmember at its top end, a fluid-driven piston cylinder and drive rodsystem connected to the base support member at the system bottom end andto the arm support member at system top end, a manually operated fluidpump and a fluid reservoir, and a fluid release mechanism.

(55) United States Patent Application Publication Number US 2007/0038217A1 to Brown et al.

United States Patent Application Publication Number US 2007/0038217 A1published to Brown et al. on Feb. 15, 2007 in U.S. class 606 andsubclass 57 teaches an orthopaedic fixation clamp for use in an externalfixation system and its method of use.

(56) United States Patent Application Publication Number US 2007/0055233A1 to Brinker.

United States Patent Application Publication Number US 2007/0055233 A1published to Brinker on Mar. 8, 2007 in U.S. class 606 and subclass 54teaches a system for externally repairing fractured bones andfacilitating alignment of displaced fractured bone segments withoutrequiring use of an external ring fixator system and tension wires. Thesystem includes at least one panel member having a plurality ofapertures extending from a first side to a second side of the panelmember. At least two pin carriers are capable of being inserted into atleast two of the plurality of apertures in the at least one panelmember. The pin carriers, upon insertion into one of the plurality ofapertures in the panel member, are longitudinally fixed relative to theaperture, but capable of rotation within the aperture. At least twohalf-pins are capable of insertion into a pin carrier, followinginsertion of the one pin carrier into one of the plurality of aperturesprovided in the panel member, toward subsequent securement to afractured bone segment. Rotation of a pin carrier causes an associatedhalf-pin inserted therein to move longitudinally with respect to thepanel member to, in turn, reposition the fractured bone segment affixedto the half-pin, relative to the panel member.

(57) International Patent Application Publication Number WO/2007/053887to Allison.

International Patent Application Publication Number WO/2007/053887published to Allison on May 18, 2007 in international patent class A61B17/60 teaches an external fixator for assisting healing of a fracture ina bone, which comprises a securing portion that defines a void, and anelongate bracket portion extends from the securing portion. The bracketportion is arranged to engage one or more first percutaneous bonefasteners locatable in the bone on a first side of the fracture. In use,one or more second percutaneous fasteners are located in the bone on asecond side of the fracture so that the second fasteners extend into thevoid of the securing portion. The void can be filled with a cementcompound to secure the second bone fasteners in place with respect tothe securing portion.

(58) United States Patent Application Publication Number US 2007/0118116A1 to Feiler et al.

United States Patent Application Publication Number 2007/0118116 A1published to Feiler et al. on May 24, 2007 in U.S. class 606 andsubclass 54 teaches a surgical appliance for assisting in the repair ofa fractured bone, such as a scaphoid bone. The device includes first andsecond adjustably interconnected and spaced apart limb clamping jawsthat are transparent to x-ray radiation and are relatively movabletoward and away from one another, and a rotatable disk carried by thefirst jaw. The disk has a plurality of bores angularly disposed thereinfor selectively aligning a guide wire to be drilled percutaneously intothe fractured bone. Each of the bores are in communication with thespace between the first and second jaws, and the longitudinal axes ofthe bores are directed to a common point intermediate the first andsecond jaws.

(59) United States Patent Application Publication Number US 2007/0123858A1 to Strub et al.

United States Patent Application Publication Number 2007/0123858 A1published to Strub et al. on May 31, 2007 in U.S. class 606 and subclass54 teaches an external fixation device having a frame including at leastone rod that takes up mechanical loads. The frame and bone are connectedvia connecting apparatus, known per se, in particular bone-retainingpins. This connecting apparatus in turn is connected to the frame viaclamping jaws. These clamping jaws permit detachable fixing andarbitrary arrangement and grouping on the frame. A module can be mountedon the frame. By way of the module, a movement of two bone fragmentsrelative to one another can be effected. It has at least two components.The first of the at least two components can be connected to the frame.The second of the at least two components can be connected to at leastone clamping jaw of a connecting apparatus that is connected to a bonefragment.

(60) United States Patent Application Publication Number US 2007/0161983A1 to Cresina et al.

United States Patent Application Publication Number US 2007/0161983 A1published to Cresina et al. on Jul. 12, 2007 in U.S. class 606 andsubclass 54 teaches an external fixation system for a bone andassociated method. The fixation system includes a proximal framedefining a continuous proximal boundary, a distal frame defining acontinuous distal boundary, and at least one frame connector configuredfor interconnecting the proximal and distal frames at any position alongat least one of the proximal and distal boundaries.

(61) International Patent Application Publication Number WO/2007/090543to Wolter et al.

International Patent Application Publication Number WO/2007/090543published to Wolter et al. on Aug. 16, 2007 in international patentclass A61B 17/60 teaches a fixation system for bone, which includes aconnecting support, at least one bone screw that can be inserted into athrough bore of the connecting support, and a sensor and telemetrysystem. The sensor and telemetry system is arranged on a separate platethat can be joined to the connecting support.

(62) United States Patent Application Publication Number US 2007/0255280A1 to Austin et al.

United States Patent Application Publication Number US 2007/0255280 A1published to Austin et al. on Nov. 1, 2007 in U.S. class 606 andsubclass 54 teaches apparatuses and methods for externally fixing andprecisely adjusting fractures, such as fractures near the ankle. In oneembodiment, an external fixation apparatus includes a first memberattachable to a first bone segment through pins, and a second membercoupled to the first member through a lockable ball joint. First andsecond ends of the second member may be translated transversely relativeto a longitudinal axis of the second member. A pin clamp is coupled toand rotatable about the second member through a lockable joint andattachable to a second bone segment. The pin clamp and the second membermay be releasably coupled.

(63) United States Patent Application Publication Number US 2007/0260243A1 to Kagami.

United States Patent Application Publication Number US 2007/0260243 A1published to Kagami on Nov. 8, 2007 in U.S. class 606 and subclass 57teaches a tower-shaped frame provided to stand upright on a positionableplatform, and a bone correction rod held by an elevating supporter. Theelevating supporter is mounted on the tower-shaped frame to beadjustably movable up and down. A bone correction rod and a weightreceiver are suspended from the elevating supporter to be movable up anddown so as to apply a load of weights to the bone correction element asa bone correction force. When the bone correction device is used, aheight of the elevating supporter is adjusted depending on a size, aposture of a body of a patient, and a position of the patient, and soforth, and a necessary weight is placed on the weight receiver dependingon the symptom of the patient, and so forth. When the bone correctionelement is applied to an affected part, a pressing force is applied tothe affected part in proportion to the weights, and hence if thepressing force is continuously applied to the affected part, anobstinate strain of a physique can be corrected.

(64) International Patent Application Publication Number WO/2007/138659to Hirata et al.

International Patent Application Publication Number WO/2007/138659published to Hirata et al. on Dec. 6, 2007 in international patent classA61B 17/60 teaches an external fixator for imparting extremely highdegrees of freedom to insertion directions of pins. The fixator isprovided with a plural number of pins to be inserted into a bone, balljoints to be, respectively, connected to these pins, and a rod-shapedmember having a plural number of connectors for connecting the balljoints together. The rod-shaped member enables the adjustment of thepositions of the connectors at least in the longitudinal direction ofthe rod-shaped member.

(65) United States Patent Application Publication Number US 2008/0021451A1 to Coull et al.

United States Patent Application Publication Number US 2008/0021451 A1published to Coull et al. on Jan. 24, 2008 in U.S. class 606 andsubclass 54 teaches an external fixator for treating a fracture of along bone, which has six extension arms that are extendable out of andretractable into a main body. The six extension arms are arranged intotwo sets of three, with each set of three extension arms being able tosupport a fixation ring. Each extension arm is pivotable at a joint andextendable so as to allow the ring to be set at a wide range of angularpositions relative to the main body. The three extension arms and thering each define a wrap angle about the axis of the long bone beingtreated. The longitudinal position of each extension arm can be changedeither with a coarse adjustment capability or with a fine adjustmentcapability, with the coarse adjustment capability being through rotationof a thumb wheel. The six extension arms are also arranged into threeopposing pairs, with each pair of extension arm shafts being disposed inan abutting relationship in the main body so that the extension armshafts extend or retract out opposing sides of the main body.

(66) United States Patent Application Publication Number US 2008/0086123A1 to Gotfried.

United States Patent Application Publication Number US 2008/0086123 A1published to Gotfried on Apr. 10, 2008 in U.S. class 606 and subclass 59teaches apparatus and method for treating a bone of a body of a patient,which includes a first member, at least a portion of which isradiolucent and arranged to be attached to the bone, an attachmentmember for attaching the first member to the bone, and a second member,at least a portion of which is radiolucent and arranged at least partlyoutside of the body of the patient and coupled to the first member. Thesecond member guides the attachment member to facilitate attachment ofthe first member to the bone via the attachment member. The partiallyradiolucent composition of the first and second members facilitatesattachment of the first member to the bone while imaging the apparatus,i.e., subjecting the apparatus and bone to X-ray imaging.

(67) United States Patent Application Publication Number US 2008/0091203A1 to Warburton et al.

United States Patent Application Publication Number US 2008/0091203 A1published to Warburton et al. on Apr. 17, 2008 in U.S. class 606 andsubclass 62 teaches an intramedullary fixation assembly usable withdifferent long bone types, and a guide assembly for guiding deploymentof the intramedullary fixation assembly. The intramedullary fixationassembly includes a fixation member that has ends and a curved bodyextending between the ends. The curved body of the fixation member has aradius of curvature configured to extend through the medullary canal,regardless of the long bone anatomy. Fasteners fix the fixation memberto the bone fragments and are guided by a guide assembly. The guideassembly includes a guide body defining openings configured to guide thefasteners through openings defined in the fixation member and into thebone fragments. A fixation end of the guide body includes a pair ofopposing, converging surfaces that are configured to engage in apositive fit, with an exposed end of the fixation member accessiblethrough the side aperture in the first fragment.

(68) International Patent Application Publication Number WO/2008/051064to Anguiano.

International Patent Application Publication Number WO/2008/051064published to Anguiano on May 2, 2008 in international patentclassification A61B 17/60 teaches an all-metal device made frompreformed elements welded to two basic sections that provide alengthening or retraction effect as required, and which once assembled,operate telescopically. The device is for use in plastic,reconstructive, and trauma surgery on the hand or the metacarpal andmetatarsal phalanges. The device can be locked using a variety ofreadily-available elements.

(69) International Patent Application Publication Number WO/2008/073238to Cresina et al.

International Patent Application Publication Number WO/2008/073238published to Cresina et al. on Jun. 19, 2008 in international patentclassification A61B 17/64 teaches an external fixation system for ajoint having a first and second bone and defining an anatomical axis ofrotation. The fixation system can include a proximal frame couplable tothe first bone and a distal frame couplable to the second bone. A firstconnector can include a first member pivotally coupled to a secondmember at a first pivot axis. A second connector can include a thirdmember pivotally coupled to a fourth member at a second pivot axis. Thefirst and second connectors are mountable between the proximal anddistal frames at a location so that the first and second pivot axes arecoaxial with the anatomical axis of rotation.

(70) United States Patent Application Publication Number US 2008/0188852A1 to Matityahu.

United States Patent Application Publication Number US 2008/0188852 A1published to Matityahu on Aug. 7, 2008 in U.S. class 606 and subclass 54teaches a medical apparatus and a method of use for use with anoutrigger and at least one fastening pin to reposition first and secondportions of a bone of a mammalian body. The apparatus includes aframework and a first fastening assembly for coupling the framework tothe outrigger, and thus the at least one fastening pin and the first endportion of the bone. The first end portion of an elongate pin isprovided with a sharpened tip for penetrating the second portion of thebone. A second fastening assembly couples the second end portion of theelongate pin to the framework. At least one adjustment assembly iscarried by at least one of the framework and the first and secondfastening assemblies for moving the first end portion of the elongatepin relative to the outrigger so as to reposition the second portion ofthe bone relative to the first portion of the bone.

(71) United States Patent Application Publication Number US 2008/0195095A1 to Renard et al.

United States Patent Application Publication Number US 2008/0195095 A1published to Renard et al. on Aug. 14, 2008 in U.S. class 606 andsubclass 54 teaches resilient external fixators between first and secondbone portions. The fixator includes a helical spring having an axis, abody, first apparatus for mounting the body to co-operate with thespring so that the spring is suitable for turning relative to the bodyabout the axis, a pin of axis suitable for being fastened on the bone,apparatus for mounting the pin to cooperate with the body so as to passthrough the spring and so that the axis forms a non-zero angle with theaxis, another body, and apparatus for connecting the body with the boneand the spring. The fixator is applicable specifically to externalfixators for fingers.

(72) United States Patent Application Publication Number US 2008/0221571A1 to Daluiski et al.

United States Patent Application Publication Number US 2008/0221571 A1published to Daluiski et al. on Sep. 11, 2008 in U.S. class 606 andsubclass 54 teaches an orthopedic external fixation system that mayinclude a distal bar having a curvature that varies along its length, anuncurved proximal bar, a plurality of proximal embedding members, and aplurality of distal embedding members. The proximal and the distalembedding members, sized and shaped for embedding in bone, may attachdirectly or indirectly to the proximal bar and the distal bar,respectively.

(73) United States Patent Application Publication Number US 2008/0221572A1 to Naegerl et al.

United States Patent Application Publication Number US 2008/0221572 A1published to Naegerl et al. on Sep. 11, 2008 in U.S. class 606 andsubclass 57 teaches a device for temporary fixation of parts of a humanjoint, which includes two holding elements disposed opposite one anotherand a releasable fixing device configured to fix in place a respectivejoint part of the human joint between the two holding elements. Inaddition, the device includes a support surface configured to support adistal joint part and a proximal joint part, a guide configured toposition and to limit a relative movement of at least one of a surgicalinstrument and a surgical aid, and receiving apparatus for receiving theguide.

(74) United States Patent Application Publication Number US 2008/0221573A1 to Kumhyr.

United States Patent Application Publication Number US 2008/0221573 A1published to Kumhyr on Sep. 11, 2008 in U.S. class 606 and subclass 59teaches an adjustment device for an external fixator, which has anelongated fixator body connected to bone-pin clamps at proximal anddistal ends of the elongated fixator body. The adjustment deviceincludes at least one adaptor for mounting to at least one of thebone-pin clamps. The adaptor stabilizes the bone-pins during anadjustment of the fractured bone to lessen the amount of painexperienced by a patient. An adjustment knob may be coupled to theadaptor and used to tighten or loosen a portion of the bone-pin clampthat facilitates rotation of the bone-pin clamp.

(75) United States Patent Application Publication Number US 2008/0255554A1 to Richter et al.

United States Patent Application Publication Number US 2008/0255554 A1published to Richter et al on Oct. 16, 2008 in U.S. class 606 andsubclass 57 teaches an external fixator having a retaining member andconnecting elements that can be connected, without screws, to a bone orbone parts, in particular to both halves of an opened sternum, andprovide for increasing or reducing the compressive stress between thetwo bone parts or sternum halves.

(76) United States Patent Application Publication Number US 2008/0269741A1 to Karidis.

United States Patent Application Publication Number US 2008/0269741 A1published to Karidis on Oct. 30, 2008 in U.S. class 606 and subclass 56teaches an orthopedic fixator for positioning a first element relativeto a second element with controlled compliance that can be adjustedduring the healing process. One embodiment includes a first frame forattachment to the first element, a second frame attached to the firstframe through a plurality of adjustable effective length struts, and athird frame for attachment to the second element. The third frame iscompliantly attached to the second frame. A preferred embodimentincludes adjustable-length preload elements to apply unidirectionalforces between the first and second frames so as preload the adjustableeffective length struts and substantially reduce the positionaltolerance. An alternative embodiment includes adjustable spring elementsallowing the compliance of the attachment of the third frame to thesecond frame to be adjusted at various points in the healing process.

(77) United States Patent Application Publication Number US 2008/0281324A1 to Webb et al.

United States Patent Application Publication Number US 2008/0281324 A1published to Webb et al. on Nov. 13, 2008 in U.S. class 606 and subclass59 teaches an external fixation assembly that includes a plurality ofhollow pins that are inserted into a patient's bone. Each pin has aninterior bore and a plurality of apertures extending through the pinwall from the bore. The pin may be coupled to a source of vacuumpressure operable to create reduced pressure in the tissue surroundingthe pin. A cover is placed around the pin and sealed to provide afluid-tight enclosure that maintains reduced pressure around the pin. Amethod for applying external fixation using the fixator pins includesthe steps of inserting each pin through a skin opening, positioning thepin apertures near selected tissue, covering the skin opening with asealed enclosure, connecting the pins to a source of vacuum pressure,and activating the source of vacuum pressure to create reduced pressurein the patient's tissue at or near the bone.

(78) United States Patent Application Publication Number US 2009/0018541A1 to Lavi.

United States Patent Application Publication Number US 2009/0018541 A1published to Lavi on Jan. 15, 2009 in U.S. class 606 and subclass 59teaches a clamp for an external fixation system that includes a bodyhaving a bottom portion and semi-spherical top portion. The top portionhas a threaded bore provided along a longitudinal axis. The clampincludes a clamp assembly having a base with a semi-spherical cavity anda lid positioned over the base to house at least one pin between thebase and the lid. The base and the lid have a bore provided along alongitudinal axis thereof. A fastening member extends through the borein the base and the lid of the clamp assembly and is secured within thethreaded bore of the top portion of the body. The bores in the base andthe lid have a diameter that is greater than the diameter of thefastening member.

(79) United States Patent Application Publication Number US 2009/0024128A1 to Nakamura et al.

United States Patent Application Publication Number US 2009/0024128 A1published to Nakamura et al. on Jan. 22, 2009 in U.S. class 606 andsubclass 54 teaches an external skeletal fixation device that reducesload on the patient, is capable of freely moving, and deformitycorrection of a bone and bone fragments. The external skeletal fixationdevice includes a pair of pin clamp units fixedly holding rodlikemembers inserted, respectively, into a first part and a second part of abone on the opposite sides, respectively, of a virtual hinge point inthe bone. The virtual hinge point corresponds to a center of rotationalangulation of the bone, a center on which the first and the second partof the bone, respectively, on the opposite sides of a fracture site ofthe bone or a part of the osteotomy site for deformity correction areturned, or a center about which a joint turns. A connecting mechanismconnecting the pair of pin clamp units has a pair of arms pivotallyconnected to the pair of pin clamp units, respectively. The pair of armsare pivotally joined together. The respective axes of rotary joints,respectively, connect the pin clamp units and the arm, and the armsextend toward the virtual hinge point.

(80) United States Patent Application Publication Number US 2009/0036889A1 to Callender.

United States Patent Application Publication Number US 2009/0036889 A1published to Callender on Feb. 5, 2009 in U.S. class 606 and subclass 55teaches a method and apparatus for treatment of sleep apnea, whichemploys bone screws implanted into a patient's anterior maxillary boneabove and posterior to the cuspids, and posterior mandibular bone belowand between any of the posterior teeth. Elastics are stretched betweenthe maxillary and mandibular bone screws to exert forces to bias themandible forward with respect to the maxilla. An aligner can be placedbetween the patient's upper and lower to help maintain properpositioning of the mandible.

(81) United States Patent Application Publication Number US 2009/0036891A1 to Brown et al.

United States Patent Application Publication Number US 2009/0036891 A1published to Brown et al. on Feb. 5, 2009 in U.S. class 606 and subclass57 teaches an orthopaedic fixation clamp for use in an external fixationsystem and its method of use.

(82) United States Patent Application Publication Number US 2009/0088751A1 to Mullaney.

United States Patent Application Publication Number US 2009/0088751 A1published to Mullaney on Apr. 2, 2009 in U.S. class 606 and subclass 59teaches clamping devices and methods for external fixation systems,which include a post component having a yaw axis, and a clamping systemsecured to the post component and rotatable about the yaw axis. Theclamping system includes an outer jaw and an inner jaw having an innersurface facing the outer jaw. The outer and inner jaws together form anopening for receiving a fixation element of the external fixationsystem. The inner jaw and outer jaw have a roll axis alignable with alongitudinal axis of the fixation element. The clamping system and postcomponent are rotatable about the roll axis. The inner jaw also includesa cylindrical outer-facing surface. The devices also include a basecomponent having a cylindrical concave surface having a pitch axis. Theconcave surface of the base component interfaces with the cylindricalouter facing component on the inner jaw. The outer and inner jaws arerotatable relative to the base and the post component about the pitchaxis.

(83) United States Patent Application Publication Number US 2009/0099565A1 to Weiner et al.

United States Patent Application Publication Number US 2009/0099565 A1published to Weiner et al. on Apr. 16, 2009 in U.S. class 606 andsubclass 54 teaches an external fixator that includes a main body and anoutrigger for extending over a fractured joint, such as a wrist joint.The main body can be positioned next to a right arm or flipped over andpositioned next to a left arm. The outrigger is attachable to extendeither to the left or to the right of the main body, as appropriate. Adistal body is removably connectable to the distal end of the main bodyand can be affixed to bone on the opposite side of the fracture toimmobilize the joint where the fracture occurs. The distal body isconnected to the main body with an adjustable securement section thatprovides six degrees of adjustment freedom. The outrigger is attached tothe main body through a slide plate in a dual rail configuration thatprovides two dimensions of adjustment. Fragment pin supports ride in atrack of the outrigger and provide seven degrees of adjustment freedomfor directed fixation of fragments at the fracture site. The outriggeris pivotally adjustable relative to the main body and includes trackportions separated by a wrap around angle. The major components of thefixator are molded of plastic. A surgical technique using the fixatorincludes immobilizing the joint for an initial healing duration andretaining fragment pins in place during a secondary healing duration.

It is apparent that numerous innovations for fixators have been providedin the prior art, which are adapted to be used. Furthermore, even thoughthese innovations may be suitable for the specific individual purposesto which they address, however, they would not be suitable for thepurposes of the embodiments of the present invention as heretoforedescribed.

BRIEF DESCRIPTION OF THE DRAWINGS

Various embodiments of the present invention will now be discussed withreference to the appended drawings. It is appreciated that thesedrawings depict only typical embodiments of the invention and aretherefore not to be considered limiting of its scope.

FIG. 1 is a diagrammatic side elevational view of the prior artdistraction apparatus taught by U.S. Pat. No. 5,074,865 to Fahmy;

FIG. 2 is a diagrammatic elevational view of the orthopedic externalfixator of the embodiments of the present invention;

FIG. 3 is a diagrammatic top plan view taken generally in the directionof ARROW 3 in FIG. 2;

FIGS. 4A-4D are a flowchart of the method for using an orthopedicapparatus for bridging between a first bone unit and a second bone unit;

FIG. 5 is a side view of a plate;

FIG. 6 is a perspective view of an operationally assembled apparatuswith a plate and two locking mechanisms;

FIG. 7 is a cross sectional view of an operationally assembled apparatuswith a plate and two locking mechanisms;

FIG. 8 is an exploded view of a plate and two locking mechanisms;

FIG. 9 is a bottom perspective view of a U-Shaped Clip lockingmechanism; and

FIG. 10 is a top perspective view of a rod locking mechanism.

LIST OF REFERENCE NUMERALS UTILIZED IN THE DRAWING

A. Prior art.

10 distraction apparatus for maintaining fractured joint 12 duringhealing

12 fractured joint

14 pair of pins for insertion into bone 16 at positions proximal to 18and distal to 20 fractured joint 12

16 bone

18 position proximal to fractured joint 12

20 position distal to fractured joint 12

22 pair of stainless steel wire springs

24 pin insertions into bone 16

B. General.

30 orthopedic apparatus of embodiments of present invention for bridgingbetween first bone unit 32 and second bone unit 34 of at least one ofinjured bone 36 and injured joint 38 for one of distraction (directionof ARROWS 40), compression (direction of ARROWS 42), static positioningand/or control range or rotational motion of at least one of the bones36 and/or joint 38

32 first bone unit

34 second bone unit

36 injured bone

38 injured joint

40 direction of ARROWS of distraction

42 direction of ARROWS of compression

C. Overall configuration of orthopedic apparatus 30.

44 first attaching apparatus for connecting apparatus 30 to first boneunit 32

46 second attaching apparatus for connecting apparatus 30 to second boneunit 34

48 control apparatus

50 reformably deformable member of control apparatus 48 that moves firstattaching apparatus 44 and second attaching apparatus 46 relative toeach other

D. Specific configuration of first attaching apparatus 44.

52 at least one first generally circular-shaped ring of first attachingapparatus 44 for receiving end 54 of at least one first pin 56,respectively, passing transversely at least into first bone unit 32

54 end of at least one first pin 56 passing transversely at least intofirst bone unit 32

56 at least one first pin passing transversely at least into first boneunit 32

58 direction of ARROWS of flexion and extension

62 center of rotation of head 64 of first bone unit 32

64 head of first bone unit 32

E. Specific configuration of second attaching apparatus 46.

66 at least one second generally circular-shaped ring of secondattaching apparatus 46 for receiving end 68 of at least one second pin70, respectively, passing transversely at least into second bone unit 34

68 end of at least one second pin 70 passing transversely at least intosecond bone unit 34

70 at least one second pin passing transversely at least into secondbone unit 34

78 rod of at least a pair of second generally circular-shaped rings 66of second attaching apparatus 46

80 one side of at least one of injured bone 36 and injured joint 38

82 other side of at least one of injured bone 36 and injured joint 38

84 other end of at least one first pin 56 [0140] 86 other end of atleast one second pin 76

F. Specific configuration of control apparatus 48.

88 generally rhombus-shaped ring of control apparatus 48

90 forward angle of generally rhombus-shaped ring 88 of controlapparatus 48

92 rearward angle of generally rhombus-shaped ring 88 of controlapparatus 48

94 top angle of generally rhombus-shaped ring 88 of control apparatus 48

96 bottom angle of generally rhombus-shaped ring 88 of control apparatus48

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

A. General.

Referring now to the figures, in which like numerals indicate likeparts, and more particularly to FIGS. 2 and 3, which are, respectively,a diagrammatic elevational view of the external fixator of theembodiments of the present invention, and a diagrammatic top plan viewtaken generally in the direction of ARROW 3 in FIG. 2, the orthopedicapparatus of the embodiments of the present invention is shown generallyat 30 for bridging between a first bone unit 32 and a second bone unit34 of at least one being an injured bone 36 and/or an injured joint 38for one of distraction (direction of ARROWS 40), compression (directionof ARROWS 42), static position, and control of range of relative rotarymotion of the at least one of the bones 36 and the joint 38.

B. The Overall Configuration of the Orthopedic Apparatus 30.

The orthopedic apparatus 30 comprises a first attaching apparatus 44, asecond attaching apparatus 46, and a control apparatus 48. The firstattaching apparatus 44 is for connecting the apparatus 30 to the firstbone unit 32. The second attaching apparatus 46 is for connecting theapparatus 30 to the second bone unit 34. The control apparatus 48 isoperatively associated with the first attaching apparatus 44 and withthe second attaching apparatus 46 to produce at least two conditions. Ina first of the conditions, the second bone unit 34 is urged in a firstdirection relative to the first bone unit 32 for one of the distraction(ARROWS 40) and the compression (ARROWS 42) of the at least one of theinjured bone 36 and the injured joint 38. In a second of the conditions,the second bone unit 34 is translated and/or rotated in a directionother than the first direction for the other one of the distraction(ARROWS 40) and the compression (ARROWS 42) of the at least one of theinjured bone 36 and/or the injured joint 38. The control apparatus 48includes a reformally deformable member 50 that moves the firstattaching apparatus 44 and the second attaching apparatus 46 relative toeach other.

The apparatus 30 is made from a material selected from the groupconsisting of stainless steel, aluminum, and brass.

C. The Specific Configuration of the First Attaching Apparatus 44.

The first attaching apparatus 44 includes at least one first generallycircular-shaped ring 52. The at least one first generallycircular-shaped ring 52 of the first attaching apparatus 44 is forreceiving an end 54 of at least one first pin 56, respectively, passingtransversely at least into the first bone unit 32.

The at least one first pin 56 is selected from the group consisting of aK-wire and a rod, each having a diameter in a range of 0.045-0.062inches.

The at least one first pin 56 is for passing transversely at least intothe center of rotation 62 of the head 64 of the first bone unit 32 so asto allow the second bone unit 34 to rotate by flexion and extension(direction of ARROWS 58) by allowing the apparatus 30 to pivot aroundthe at least one first pin 56 when the at least one first pin 56 is onefirst pin 56.

D. The Specific Configuration of the Second Attaching Apparatus 46.

The second attaching apparatus 46 includes at least one second generallycircular-shaped ring 66. The at least one second generallycircular-shaped ring 66 of the second attaching apparatus 46 is forreceiving an end 68 of at least one second pin 70, respectively, passingtransversely at least into the second bone unit 34.

The at least one second pin 70 is selected from the group consisting ofa K-wire and a rod, each having a diameter in a range of 0.045-0.062inches.

The at least one second generally circular-shaped ring 66 of the secondattaching apparatus 46 is at least a pair of second generallycircular-shaped rings 66. The at least one pair of second generallycircular-shaped rings 66 of the second attaching apparatus 46 receivesat least a pair of second pins 70, respectively.

The at least one pair of second generally circular-shaped rings 66 ofthe second attaching apparatus 46 are connected to each other by a rod78.

As shown in FIG. 3, the apparatus 30 is for positioning on one side 80of the at least one of the injured bone 36 and the injured joint 38.Another apparatus 30 is for positioning on the other side 82 of the atleast one of the injured bone 36 and the injured joint 38 and receivesthe other end 84 of the at least one first pin 56, respectively, and theother end 86 of the at least one second pin 70, respectively.

E. The Specific Configuration of the Control Apparatus 48.

The control apparatus 48 includes a generally rhombus-shaped ring 88.The generally rhombus-shaped ring 88 of the control apparatus 48 isstraddled by the at least one first generally circular-shaped ring 52 ofthe first attaching apparatus 44 and the at least one second generallycircular-shaped ring 66 of the second attaching apparatus 46.

The generally rhombus-shaped ring 88 of the control apparatus 48 has aforward angle 90 and a rearward angle 92. The at least one secondgenerally circular-shaped ring 66 of the second attaching apparatus 46extends forwardly from the forward angle 90 of the generallyrhombus-shaped ring 88 of the control apparatus 48. The at least onefirst generally circular-shaped ring 52 of the first attaching apparatus44 extends rearwardly from the rearward angle 92 of the generallyrhombus-shaped ring 88 of the control apparatus 48.

The generally rhombus-shaped ring 88 of the control apparatus 48 has atop angle 94 and a bottom angle 96. The top angle 94 of the generallyrhombus-shaped ring 88 of the control apparatus 48 and the bottom angle96 of the generally rhombus-shaped ring 88 of the control apparatus 48when moved cause the generally rhombus-shaped ring 88 of the controlapparatus 48 to deform and move the first attaching apparatus 44 and thesecond attaching apparatus 46 relative to each other, and in doing so,moves the first bone unit 32 and the second bone unit 34 relative toeach other.

The generally rhombus-shaped ring 88 of the control apparatus 48 is madefrom a non-memory metal so as to allow it to maintain its deformed shapeonce deformed, and is deformed to move the first attaching apparatus 44and the second attaching apparatus 46 relative to each other in a rangeof 1-3 mm.

F. The Method for Using the Orthopedic Apparatus 30 for Bridging Betweenthe First Bone Unit 32 and the Second Bone Unit 34 of the at Least Oneof the Injured Bone 36 and the Injured Joint 38 for One of theDistraction, the Compression, the Static Positioning and/or Control ofRange of Relative Rotary Motion of the at Least One of the Bones 36and/or the Joint 38.

The method for using the orthopedic apparatus 30 for bridging betweenthe first bone unit 32 and the second bone unit 34 of the at least oneof the bones 36 and/or the joint 38 for one of the distraction, thecompression, the static positioning and/or control of range of relativemotion of the at least one of the bones 36 and/or the joint 38 can bestbe seen in FIGS. 4A-4ZZ, which are a flowchart of the method for usingan orthopedic apparatus for bridging between a first bone unit and asecond bone unit, and as such, will be discussed with reference thereto.

The method for using the orthopedic apparatus 30 for bridging betweenthe first bone unit 32 and the second bone unit 34 of the at least oneof the bones 36 and/or the joint 38 for one of the distraction, thecompression, the static positioning and/or the control of range orrelative motion of the at least one of the bones 36 and the joint 38comprises the steps of: [0164] STEP 1: Inserting the at least one firstpin 56 transversely at least into the first bone unit 32, leaving theend 54 of the at least one first pin 56 sticking out from the first boneunit 32 on the one side 80 of the at least one of the bones 36 and/orthe joint 38. [0165] STEP 2: Inserting the at least one second pin 70transversely at least into the second bone unit 34, leaving the end 68of the at least one second pin 70 sticking out from the second bone unit34 on the one side 80 of at the least one of the bones 36 and the joint38. [0166] STEP 3: Positioning the apparatus 30 on the one side 80 ofthe at least one of the bones 36 and the joint 38. [0167] STEP 4:Sliding the first attaching apparatus 44 over the end 54 of the at leastone first pin 56 so as to allow the first attaching apparatus 44 topivot relative to the at least one first pin 56 when the at least onefirst pin 56 is one first pin 56, and sliding the second attachingapparatus 46 over the end 68 of the at least one second pin 70,respectively, and in doing so, mounting the apparatus 30 to the at leastone first pin 56 and to the at least one second pin 70. [0168] STEP 5:Crimping the end 54 of the at least one first pin 56 and crimping theend 68 of the at least one second pin 70, and in so doing, affixing theapparatus 30 to the at least one first pin 56 and to the at least onesecond pin 70. [0169] STEP 6: Deforming the control apparatus 48 toproduce at least two conditions. In a first of the conditions, thesecond bone unit 34 is urged in a first direction relative to the firstbone unit 32 for one of the distraction, the compression, the staticpositioning and/or the control of range or relative rotary motion of theat least one of the bones 36 and/or the joint 38. In a second of theconditions, the second bone unit 34 is urged in a direction other thanthe first direction for the other one of the distraction, thecompression, the static positioning and/or the control of range orrelative rotary motion of the at least one of the bones 36 and the joint38.

FIGS. 5-8 depict an apparatus 100 for bridging between a first bone unitand a second bone unit. The apparatus illustrated in FIGS. 5-8 mayinclude features similar to those described above. The apparatus mayinclude at least one attachment portion and a control portion. Theattachment portion may include a locking mechanism.

FIG. 5 depicts a plate 110, wherein the plate 110 includes twoattachment portions 140 and 180. The plate 110 may also be referred toas a body, frame, bracket, or scaffold. The plate 110 may include afirst surface 112 that extends between a first end 116 and a second end118, and a second surface 114 opposite the first surface 112. The plate110 may also include a first side 120 that extends between the first end116 and the second end 118, and extends between the first surface 112and the second surface 114. The plate 110 may also include a second side122 opposite the first side 120.

The plate 110 may include a medial control portion 130 between the twoattachment portions 140, 180. The medial control portion 130 may besubstantially diamond shaped or rhombus shaped, wherein the plate 110may comprise the boundary 132 of the diamond and the middle portion 134may be hollow.

The first attachment portion 140 may extend between the first end 116 ofthe plate 110 and the control portion 130. The second attachment portion180 may extend between the control portion 130 and the second end 118 ofthe body. These positions may be reversed, or only one of the attachmentportions 140, 180 may be present.

As seen best in FIG. 5, the first attachment portion 140 may besubstantially rectangular, and may be shaped to receive an externalU-shaped locking member 150, described below. The first attachmentportion 140 may include a first side 142 that is recessed from the firstside 120 of the plate 110, and extends from the first end 116 of theplate 110 to the medial control portion 130. The first attachmentportion 140 may also include a second side 144, which may be continuouswith the second side 122 of the plate 110 and is opposite the first side142 of the first attachment portion 140. The first attachment portionmay contain a plurality of apertures. In the example shown, the firstattachment portion 140 includes a first aperture 146 and a secondaperture 148. The apertures 146, 148 may be substantially circular andmay be shaped to each receive at least one bone fragment fixation pin.The pin may be selected from the group consisting of a K-wire and a rod.

In an alternative embodiment, the first side 142 of the first attachmentportion 140 may include a dovetail or rail feature, designed to fit intoa complementary groove feature on a top interior surface 154 of acentral channel 152 in the U-shaped locking member 150.

The second attachment portion 180 of the plate 110 may also include aplurality of apertures and may be shaped to receive an internal lockingmechanism that includes a rod 190 and a set screw 191, described below.The apertures may be substantially circular and may be shaped to receiveat least one bone fragment fixation pin. The pin may be selected fromthe group consisting of a K-wire and a rod. As best seen in FIGS. 5-8,the second attachment portion 180 includes four apertures 181, 182, 183,184. The second attachment portion 180 may also include a tunnel 185that intersects the second end 118 of the plate 110. The tunnel 185 mayalso be referred to as a channel or a bore, and may be shaped to receivea rod 190. The tunnel 185 may include a threaded portion 186 thatintersects the second end 118 of the plate 110. As seen best in FIG. 8,the rod 190 may be operatively assembled with the second attachmentportion 180 by sliding the rod into the tunnel 185. The rod 190 may beadvanced in the tunnel 185 and secured in the tunnel 185 by a threadedset screw 191 that fastens to the threaded portion 186 of the tunnel185.

As shown best in FIGS. 8 and 9, the U-shaped locking member or clip 150may be formed separately from the plate 110 and may include the centralchannel 152, wherein the central channel 152 may be shaped to receivethe first attachment portion 140 of the plate 110. The central channel152 may include the top interior surface 154. The U-shaped clip 150 mayinclude a first ridge 156 and a second ridge 158. The first ridge 156may include a first interior surface 160 that intersects the topinterior surface 154 of the channel, and a first exterior surface 162that is opposite the first interior surface 160. The second ridge 158may include a second interior surface 166 that intersects the topinterior surface 154 of the channel 152, and a second exterior surface168 that is opposite the second interior surface 166. The first ridge156 may also include a first basal surface 164, and the second ridge 158may include a second basal surface 169.

In an alternative embodiment, basal surfaces 164, 169 of a first ridge156 and a second ridge 158 may be oriented towards a central channel152, such that when the U-shaped clip 150 is advanced over the firstattachment portion 140, the basal surfaces 164, 169 can extend beyondthe second side 144 of the first attachment portion 140 and clamp inwardto further secure the clip 150 to the plate 110.

The width of the central channel 152 may be slightly smaller than thewidth of the first attachment portion 140, so that the central channelreceives the first attachment portion with interference. The U-shapedclip 150 may also include a plurality of cutouts, wherein the cutoutsmay extend across the central channel 152. The number of cutouts may beequal to the number of apertures in the first attachment portion 140 ofthe plate 110. In the example shown, the U-shaped clip 150 contains twosubstantially semi-circular cutouts 170, 172. The cutouts 170, 172 mayextend from the first and second basal surfaces 164, 169 of the firstand second ridges 156, 158. The circumference of the cutouts 170, 172may be slightly smaller than the circumference of the apertures. Thecutouts may include circumferential edges that may be beveled orsharpened 174.

As seen best in FIG. 10, the rod 190 may include an elongated shaft 192portion 192, and a head portion 194. The head portion 194 may beintegral to the shaft 192 and the shaft 192 may be located eccentricallyor asymmetrically on the head 194. The elongated shaft 192 may include aplurality of cutouts 195, 196, 197, 198. The cutouts 195, 196, 197, 198may comprise a rounded surface portion 199 and a flat bottom portion193.

FIGS. 6-7 illustrate the plate 110 described in FIG. 5 operativelyassembled with a first U-shaped clip locking mechanism 150 and a secondrod locking mechanism 190. Each of the locking mechanisms may bereceived on a portion of the plate 110. In the example shown in FIGS. 6and 7, the first locking mechanism 150 is received by the firstattachment portion 140 and the second locking mechanism 190 is receivedby the second attachment portion 180. The first and second lockingmechanisms 150, 190 may also be referred to as first and second lockingmembers, locking apparatuses or locking features. The first lockingmember 150 may be operatively assembled with the first attachmentportion 140 by sliding the clip over the first side 142 of the firstattachment portion 140, as seen best in FIGS 6 and 8.

In operation, the first attachment portion 140 may be placed against afirst bone segment. A K-wire may be placed into at least one of theapertures and further into the bone segment. Additional K-wires may beplaced through apertures as needed. The U-shaped clip locking member 150may be placed onto the first side 142 of the first attachment portion140 such that the cutouts 170, 172 align with the apertures 146, 148 inthe first attachment portion 140. The U-shaped clip 150 may then beadvanced toward the second side 144 of the first attachment portion 140such that the first ridge 156 and the second ridge 158 deflect outwardsfrom the central channel to receive the first attachment portion 140 ofthe plate 110. For example, the clip 150 may slide in a direction thatis oblique, transverse, or perpendicular to the apertures 146, 148. Whenthe U-shaped clip 150 is advanced to fully receive the first attachmentportion 140, the cutouts 170, 172 may at least partially overlap theapertures 146, 148 and the sharpened edges 174 of the cutouts 170, 172may cut a groove into the surfaces of the K-wires. This may provide aninterference fit with the K-wires, and thus may secure the K-wires tothe plate 110.

In operation, the second attachment portion 180 may be placed against asecond bone segment. The rod 190 may be placed into the tunnel 185, suchthat the rod 190 is positioned closer to the second side 122 of theplate 110, and such that the rounded surfaces 199 of the cutouts 195,196, 197, 198 are disposed towards the first side 120 of the plate 110.A K-wire may be extended through each of the apertures 181, 182, 183,184, and further into the second bone segment. After the pins have beenplaced through the apertures 181, 182, 183, 184 and into the bonesegment, the set screw 191 may be actuated such that as it turns, it mayact on the head 194 of the rod 190 to advance the rod 190 in the tunnel185 toward the first end 116 of the plate 110. As the rod 190 isadvanced in the tunnel 185, the cutouts 195, 196, 197, 198 at leastpartially overlap the apertures 181, 182, 183, 184, and contact thepins, such that the pins become fixed against the side of the aperturesand thus become secured to the plate 110.

In an alternative embodiment, the set screw 191 may be integral to therod 190. In this example, the rod and set screw may be coaxial.Actuation of the threaded screw portion turns the rod and simultaneouslydrives it along tunnel 185 to wedge pins to the plate. The clampingaction may be due to rotation of the cutouts 195, 196, 197, 198 againstthe pins, axial advancement of the cutouts 195, 196, 197, 198 againstthe pins, or both.

The medial control portion 130 may include a generally diamond-shaped orrhombus-shaped ring, which may be deformable as described above. Thediamond-shaped ring 130 may include four interior angles 135, 136, 137,138, which may be defined by the boundary 132 of the diamond 130. Angle135 may be located nearest the first side 120 of the plate 110. Angle136 may be located nearest the second side 122 of the plate 110. Angle137 may be located nearest the first end 116 of the plate 110 and angle138 may be located nearest the second end 118 of the plate 110.

In operation, the medial control portion 130 may be compressed such thatangles 137 and 138 become more obtuse and such that the distance betweenthe first end 116 of the plate 110 and the second end 118 of the plate110 becomes less. Alternatively, the medical control portion 130 may bestretched such that angles 135 and 136 become more obtuse, and thedistance between the first end 116 of the plate 110 and the second end118 of the plate 110 increase.

G. The Impressions.

It will be understood that each of the elements described above or twoor more together may also find a useful application in other types ofconstructions differing from the types described above.

While the embodiments of the present invention have been illustrated anddescribed as embodied in a orthopedic external fixator and method ofuse, however, they are not limited to the details shown, since it willbe understood that various omissions, modifications, substitutions, andchanges in the forms and details of the embodiments of the presentinvention illustrated and their operation can be made by those skilledin the art without departing in any way from the spirit of theembodiments of the present invention.

Without further analysis the foregoing will so fully reveal the gist ofthe embodiments of the present invention that others can by applyingcurrent knowledge readily adapt them for various applications withoutomitting features that from the standpoint of prior art fairlyconstitute characteristics of the generic or specific aspects of theembodiments of the present invention.

1. An apparatus for bridging between a first bone unit and a second boneunit, the apparatus comprising: a pin; a plate, the plate comprising: afirst attachment portion a second attachment portion, wherein the secondattachment portion comprises an aperture for receiving the pin, whereinthe second attachment portion comprises a locking mechanism, whereinwhen the locking member is actuated the pin becomes fixed relative tothe plate; a control portion, wherein the control portion is operativelyassembled with the first attachment portion and the second attachmentportion, wherein when the control portion is moved in a first direction,the first attachment portion is urged in a first direction relative tothe second attachment portion, and when the control portion is moved ina second direction, the first attachment portion is moved in a seconddirection relative to the second attachment portion.
 2. The system ofclaim 1, wherein the locking mechanism comprises a cutout.
 3. The systemof claim 2, wherein the cutout is formed to engage with a side of thepin.
 4. The system of claim 2, wherein the cutout engages the pin bywedging the pin against the plate.
 5. The system of claim 2, wherein thecutout engages the pin through interference with the side of the pin. 6.The system of claim 2, wherein the radius of the cutout is smaller thanthe radius of the pin.
 7. The system of claim 2, wherein when the cutoutengages the pin, the cutout at least partially overlaps the aperture. 8.The system of claim 2, wherein the cutout comprises a sharp edge thatgouges a side of the pin to fix the pin to the plate.
 9. The system ofclaim 1, wherein the locking mechanism comprises an unlocked setting anda locked setting.
 10. The system of claim 9, wherein when the lockingmechanism is in the unlocked position, the cutout is positioned toprovide a loose fit for the pin, wherein when the locking mechanism isin the locked position, the cutout is positioned to provide aninterference fit for the pin.
 11. The system of claim 9, wherein whenthe locking mechanism is in the unlocked position, the cutout does notpartially overlap the aperture, wherein when the locking mechanism is inthe locked position, the cutout is positioned such that it partiallyoverlaps the aperture.
 12. The system of claim 9, wherein when thelocking mechanism is in the unlocked position, the cutout is positionedsuch that it is displaced away from the pin, wherein when the lockingmechanism is in the locked position, the cutout is positioned such thatit engages the pin.
 13. The system of claim 9, wherein when the lockingmechanism is in the unlocked position, the cutout is positioned suchthat it is displaced from the aperture, wherein when the lockingmechanism is in the locked position, the cutout is positioned such thatit partially overlaps the aperture.
 14. The system of claim 1, whereinthe apparatus comprises multiple pins, wherein the plate comprisesmultiple apertures to receive the pins.
 15. The system of claim 14,wherein the plate comprises a separate locking mechanism for each pin.16. The system of claim 14, wherein the locking mechanism is configuredto lock at least two pins to the plate.
 17. The system of claim 14,wherein the locking mechanism is configured to lock at least two pins tothe plate simultaneously.
 18. The system of claim 1, wherein the lockingmechanism is internal to the plate.
 19. The system of claim 18, whereinthe locking mechanism comprises a rod.
 20. The system of claim 19,wherein the rod moves transverse to the aperture to engage the pin. 21.The system of claim 19, wherein the rod moves transverse to the apertureto partially overlap the aperture.
 22. The system of claim 18 whereinthe locking mechanism comprises a rod and a threaded element.
 23. Thesystem of claim 22, wherein the rod and the threaded element areintegral.
 24. The system of claim 23, wherein the rod and threadedelement move axially and rotationally transverse to the aperture to lockthe pin to the plate.
 25. The system of claim 22, wherein the rod andthe threaded element are formed separately.
 26. The system of claim 25,wherein the threaded element moves the rod transverse to the aperturesto lock the pin to the plate.
 27. The system of claim 1, wherein thelocking member comprises a clip feature.
 28. The system of claim 27,wherein the clip is captive to the plate.
 29. The system of claim 27,wherein the clip is captive to the plate when the locking mechanism isin the locked configuration.
 30. The system of claim 27, wherein theclip is captive to the plate when the locking mechanism is in theunlocked configuration.
 31. The system of claim 1, wherein the platecomprises a first attachment portion, wherein the first attachmentportion comprises a plurality of apertures, wherein the plate comprisesa control portion, wherein the plate also comprises a second attachmentportion, wherein the second attachment portion comprises a plurality ofapertures, wherein the second attachment portion also comprises alocking mechanism.
 32. The system of claim 1, wherein the platecomprises a first attachment portion, wherein the first attachmentportion comprises a plurality of apertures, wherein the first attachmentportion also comprises a dovetail feature to engage a clip lockingmember, wherein the plate comprises a control portion, wherein the platealso comprises a second attachment portion, wherein the secondattachment portion comprises a plurality of apertures, wherein thesecond attachment portion also comprises an integral rod lockingmechanism.
 33. A system comprising: a pin; a plate, the plate comprisinga hole to receive the pin; and a locking mechanism that locks the pin tothe plate, wherein the locking mechanism slides transverse to the holeto lock the pin to the plate.
 34. The system of claim 33, wherein thelocking mechanism comprises a cutout.
 35. The system of claim 34,wherein the cutout is formed to engage with a side of the pin.
 36. Thesystem of claim 34, wherein the cutout engages the pin by wedging thepin against the plate.
 37. The system of claim 34, wherein the cutoutengages the pin through interference with the side of the pin.
 38. Thesystem of claim 34, wherein the radius of the cutout is smaller than theradius of the pin.
 39. The system of claim 34, wherein when the cutoutengages the pin, the cutout at least partially overlaps the aperture.40. The system of claim 34, wherein the cutout comprises a sharp edgethat gouges a side of the pin to fix the pin to the plate.
 41. Thesystem of claim 33, wherein the locking mechanism comprises an unlockedsetting and a locked setting.
 42. The system of claim 41, wherein whenthe locking mechanism is in the unlocked position, the cutout ispositioned to provide a loose fit for the pin, wherein when the lockingmechanism is in the locked position, the cutout is positioned to providean interference fit for the pin.
 43. The system of claim 41, whereinwhen the locking mechanism is in the unlocked position, the cutout doesnot partially overlap the aperture, wherein when the locking mechanismis in the locked position, the cutout is positioned such that itpartially overlaps the aperture.
 44. The system of claim 41, whereinwhen the locking mechanism is in the unlocked position, the cutout ispositioned such that it is displaced away from the pin, wherein when thelocking mechanism is in the locked position, the cutout is positionedsuch that it engages the pin.
 45. The system of claim 41, wherein whenthe locking mechanism is in the unlocked position, the cutout ispositioned such that it is displaced from the aperture, wherein when thelocking mechanism is in the locked position, the cutout is positionedsuch that it partially overlaps the aperture.
 46. The system of claim33, wherein the apparatus comprises multiple pins, wherein the platecomprises multiple apertures to receive the pins.
 47. The system ofclaim 46, wherein the plate comprises a separate locking mechanism foreach pin.
 48. The system of claim 46, wherein the locking mechanism isconfigured to lock at least two pins to the plate.
 49. The system ofclaim 46, wherein the locking mechanism is configured to lock at leasttwo pins to the plate simultaneously.
 50. The system of claim 33,wherein the locking mechanism is internal to the plate.
 51. The systemof claim 50, wherein the locking mechanism comprises a rod.
 52. Thesystem of claim 51, wherein the rod moves transverse to the aperture toengage the pin.
 53. The system of claim 51, wherein the rod movestransverse to the aperture to partially overlap the aperture.
 54. Thesystem of claim 50, wherein the locking mechanism comprises a rod and athreaded element.
 55. The system of claim 54, wherein the rod and thethreaded element are integral.
 56. The system of claim 55, wherein therod and threaded element move axially and rotationally transverse to theaperture to lock the pin to the plate.
 57. The system of claim 54,wherein the rod and the threaded element are formed separately.
 58. Thesystem of claim 57, wherein the threaded element moves the rodtransverse to the apertures to lock the pin to the plate.
 59. The systemof claim 33, wherein the locking member comprises a clip feature. 60.The system of claim 59, wherein the clip is captive to the plate. 61.The system of claim 59, wherein the clip is captive to the plate whenthe locking mechanism is in the locked configuration.
 62. The system ofclaim 59, wherein the clip is captive to the plate when the lockingmechanism is in the unlocked configuration.
 63. The system of claim 33,wherein the plate comprises a first attachment portion, wherein thefirst attachment portion comprises a plurality of apertures, wherein theplate comprises a control portion, wherein the plate also comprises asecond attachment portion, wherein the second attachment portioncomprises a plurality of apertures, wherein the second attachmentportion also comprises a locking mechanism.
 64. The system of claim 33,wherein the plate comprises a first attachment portion, wherein thefirst attachment portion comprises a plurality of apertures, wherein thefirst attachment portion also comprises a dovetail feature to engage aclip locking member, wherein the plate comprises a control portion,wherein the plate also comprises a second attachment portion, whereinthe second attachment portion comprises a plurality of apertures,wherein the second attachment portion also comprises an integral rodlocking mechanism.
 65. A system comprising: a pin; a plate, the platecomprising a hole to receive the pin; and a locking mechanism that locksthe pin to the plate, wherein the locking mechanism slides transverse tothe pin to lock the pin to the plate.
 66. The system of claim 65,wherein the locking mechanism comprises a cutout.
 67. The system ofclaim 66, wherein the cutout is formed to engage with a side of the pin.68. The system of claim 66, wherein the cutout engages the pin bywedging the pin against the plate.
 69. The system of claim 66, whereinthe cutout engages the pin through interference with the side of thepin.
 70. The system of claim 66, wherein the radius of the cutout issmaller than the radius of the pin.
 71. The system of claim 66, whereinwhen the cutout engages the pin, the cutout at least partially overlapsthe aperture.
 72. The system of claim 66, wherein the cutout comprises asharp edge that gouges a side of the pin to fix the pin to the plate.73. The system of claim 65, wherein the locking mechanism comprises anunlocked setting and a locked setting.
 74. The system of claim 73,wherein when the locking mechanism is in the unlocked position, thecutout is positioned to provide a loose fit for the pin, wherein whenthe locking mechanism is in the locked position, the cutout ispositioned to provide an interference fit for the pin.
 75. The system ofclaim 73, wherein when the locking mechanism is in the unlockedposition, the cutout does not partially overlap the aperture, whereinwhen the locking mechanism is in the locked position, the cutout ispositioned such that it partially overlaps the aperture.
 76. The systemof claim 73, wherein when the locking mechanism is in the unlockedposition, the cutout is positioned such that it is displaced away fromthe pin, wherein when the locking mechanism is in the locked position,the cutout is positioned such that it engages the pin.
 77. The system ofclaim 73, wherein when the locking mechanism is in the unlockedposition, the cutout is positioned such that it is displaced from theaperture, wherein when the locking mechanism is in the locked position,the cutout is positioned such that it partially overlaps the aperture.78. The system of claim 65, wherein the apparatus comprises multiplepins, wherein the plate comprises multiple apertures to receive thepins.
 79. The system of claim 78, wherein the plate comprises a separatelocking mechanism for each pin.
 80. The system of claim 78, wherein thelocking mechanism is configured to lock at least two pins to the plate.81. The system of claim 78, wherein the locking mechanism is configuredto lock at least two pins to the plate simultaneously.
 82. The system ofclaim 65, wherein the locking mechanism is internal to the plate. 83.The system of claim 82, wherein the locking mechanism comprises a rod.84. The system of claim 83, wherein the rod moves transverse to theaperture to engage the pin and to fix the pin to the plate.
 85. Thesystem of claim 83, wherein the rod moves transverse to the aperture topartially overlap the aperture.
 86. The system of claim 82, wherein thelocking mechanism comprises a rod and a threaded element.
 87. The systemof claim 86, wherein the rod and the threaded element are integral. 88.The system of claim 87, wherein the rod and threaded element moveaxially and rotationally transverse to the aperture to lock the pin tothe plate.
 89. The system of claim 86, wherein the rod and the threadedelement are formed separately.
 90. The system of claim 89, wherein thethreaded element moves the rod transverse to the apertures to lock thepin to the plate.
 91. The system of claim 65, wherein the locking membercomprises a clip feature.
 92. The system of claim 91, wherein the clipis captive to the plate.
 93. The system of claim 91, wherein the clip iscaptive to the plate when the locking mechanism is in the lockedconfiguration.
 94. The system of claim 91, wherein the clip is captiveto the plate when the locking mechanism is in the unlockedconfiguration.
 95. The system of claim 65, wherein the plate comprises afirst attachment portion, wherein the first attachment portion comprisesa plurality of apertures, wherein the plate comprises a control portion,wherein the plate also comprises a second attachment portion, whereinthe second attachment portion comprises a plurality of apertures,wherein the second attachment portion also comprises a lockingmechanism.
 96. The system of claim 65, wherein the plate comprises afirst attachment portion, wherein the first attachment portion comprisesa plurality of apertures, wherein the first attachment portion alsocomprises a dovetail feature to engage a clip locking member, whereinthe plate comprises a control portion, wherein the plate also comprisesa second attachment portion, wherein the second attachment portioncomprises a plurality of apertures, wherein the second attachmentportion also comprises an integral rod locking mechanism.